SERVICES
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| In Vitro Fertilization (IVF) |
Beginning an IVF cycle is an exciting and
anxious time for a couple. Our Center provides couples with
the maximum amount of clinical, emotional, and administrative
support they will need to complete their cycle successfully
- whether it results in a pregnancy or not.
The following explanation is meant to simplify what occurs
during various stages of IVF: |
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| Ovarian Follicle Development through
Controlled Ovarian Stimulation |
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Rotunda Blue Fertility Clinic uses fertility drugs
that simulate the female partner, natural hormones to develop
several normal follicles in the ovaries. These medications
are Clomiphene Citrate also called Siphene®
or Ovofar®; Menogon (HMG),
a 50:50 mixture of FSH and LH hormonal administered intramuscularly;
Puregon® (POFSH) administered subcutaneously;
or Gonal-F (RecFSH). Any excess Oocytes that
fertilize and develop into embryos at fertilization may later
be stored through cryopreservation. |
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| Follicular growth, development, and maturity
are evaluated through frequent hormone monitoring and by ultrasounds.
Typically, the hormones estradiol, luteinizing hormone, and
progesterone are measured through blood tests to evaluate ovarian
response. Ultrasound is used several times during a cycle to
measure accurately follicular growth and size. |
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| These steps allow the physician team to modify
the treatment in some cases and to stop the cycle if the response
to stimulation is not satisfactory. Once follicular maturation
is achieved, the patient receives an intramuscular injection
of human chorionic gonadotropin (hCG), which triggers oocyte
maturation and ovulation. Oocyte retrieval is performed approximately
34 hours later. |
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| Embryo Retrieval through Puncture/Aspiration |
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| If the last hormone blood test and ultrasound
evaluation indicates healthy growth of follicles, then
aspiration of mature follicles takes place. This entire
procedure takes approximately 20 minutes performed under
short general anesthesia. The physician locates each follicle
through ultrasonic guidance and carefully aspirates them.
The contents of the follicles are immediately taken to
the IVF lab. Patients usually recover for one to two hours
following Oocyte retrieval and are then discharged. Progesterone
supplementation is initiated from the day of the retrieval.
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| Oocyte Culture, Insemination, and
Fertilization |
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| In the IVF laboratory, follicular fluid
is examined under a microscope to locate all eggs, which
are then incubated in a special media. Generally, semen
collection occurs at about the time of the egg retrieval
but, in some cases, may be several hours later. The sperms
are then added to the eggs in culture, here fertilization
occurs. Any resulting embryos are stored in the incubator,
and maintained in culture until the time of embryo transfer
and/or Cryopreservation. |
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Embryo Transfer |
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| Usually, transfer of the embryos takes
place on day two to three post retrieval. The embryos
are examined under the microscope and carefully aspirated
to a thin transfer catheter. The loaded catheter is introduced
under transabdominal ultrasound guidance through the cervix
into the uterus where the embryos are placed. This procedure
takes a few minutes and does not require anesthesia. |
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| After the transfer, the patient rests for
two hours prior to discharge. Twelve days after the embryo
transfer, a serum base pregnancy test is taken. During
this period, patients are advised to perform light activity
and remain in contact with the Center. If pregnancy does
not occur, our team reviews the IVF cycle and makes specific
recommendations for follow-up. The patient will speak
with the clinical staff to review and if necessary, to
discuss other options. |
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Cryopreservation |
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| Embryos of sufficient quality that are not
transferred can be cryopreserved. The embryologist will select
embryos that are suitable for freezing. Embryos that are ideal
for freezing have blastomeres of equal size and display minimal
or no fragmentation. |
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| A Word of Caution: There is approximately
a 68% chance of survival following the cryopreserved embryos.
The quality of embryos undergoing cryopreservation is a major
determinant of survival. Depending on the stage of embryo development,
frozen embryos are thawed for 2 days before the transfer. The
patient is informed of survival of the thawed embryos and posted
for a Frozen Thawed Embryo transfer ( FET). |
Ovarian Follicle: A small, fluid-filled structure in which eggs develop
Oocyte: An egg
Embryo: A fertilized Egg that has undergone division cleavage |
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